By Emma Black
The phrase, “COVID-19 vaccines are safe and effective”, is repeated around the world; on the Centre for Disease Control (CDC) website, WHO vaccine tracker sites and most news sites including the BBC, CNN, New York Times, etc.
And yes, that phrase is 99.9 per cent accurate. On 30 January 2020, scientific/academic institutions and manufacturers started work on the development of COVID-19 vaccines, after the WHO declaration of a public health emergency of international concern (PHEIC).
Tens of thousands of people participated in clinical trials. And, the vaccines met the US Food and Drug Administration’s – FDA’s rigorous scientific standards for safety, effectiveness, and manufacturing quality.
Vaccines are the most complex medical products to develop; from a broad concept all the way to a level of assurance that their use will provide more benefits than risks. Vaccines involve a jolt or stimulus to the immune system with an infectious agent or parts of an infectious agent, like COVID-19. But, these parts are altered slightly to ensure that the vaccine does not cause sickness in the person receiving the vaccine. If or when a person comes in contact with the infection, their immune system already has the answer and controls the infection before it causes sickness.
Dr Tom Sesay, head of Sierra Leone’s Expanded Programme on Immunisation (EPI), said, ‘The COVID-19 vaccination programme aims to give doses to nearly every adult around the world. This is the largest vaccination programme in history; bigger than polio, measles, and so on.’ He continued, ‘COVID-19 vaccines were developed using scientific methods that have been around for decades and the evidence has shown that these vaccines are safe and effective.’
In the Sierra Leone National COVID-19 Emergency Response Centre (NaCOVERC) and Ministry of Health and Sanitation statistical announcement on 23 January 2022, they reported 1,147,770 people have received one dose of vaccine, or 13.8 per cent of the population of around 7 million. 692,512 are fully vaccinated or just 8.3 per cent of the population.
More than five billion people worldwide have received at least one dose of a COVID-19 vaccine, equal to about 66.4 per cent of the world’s population. More than 11.2 billion doses of Coronavirus vaccines have been administered in at least 197 countries. A vaccinated person refers to someone who has received at least one dose of a vaccine, and a fully vaccinated person has received either a single-dose vaccine or both doses of a two-dose vaccine, such as the Pfizer and Moderna shots.
But, perhaps in a case where “the exception proves the rule”, there have been adverse side effects from COVID-19 vaccines reported. No medicine or vaccine is ever entirely risk-free. In the US, five people per million have reported an allergic reaction known as anaphylaxis. Anaphylaxis, a severe type of allergic reaction, can occur after any kind of vaccination.
Between 14 December 2020 and 18 January 2021, over 9.9 million doses of the Pfizer vaccine and over 7.5 million of Moderna’s were administered. In this same time, CDC identified 66 anaphylaxis cases reported to the Vaccine Adverse Event Reporting System (VAERS): 47 following Pfizer vaccination (rate of 4.7 cases per million doses) and 19 following Moderna’s (rate of 2.5 cases per million doses). There were no deaths from anaphylaxis reported after either vaccine.
In a study done on the Johnson & Johnson vaccine, more than 18.5 million doses of the J&J/Janssen COVID-19 vaccine were administered in the US as of March 2022. CDC and FDA identified 60 confirmed reports of people who got the J&J/Janssen COVID-19 vaccine and later developed thrombosis with thrombocytopenia syndrome (TTS), or blood clots in large blood vessels. The CDC also identified nine deaths that have been caused by or were directly attributed to TTS following J&J COVID-19 vaccination.
According to the WHO, serious adverse reactions to any of the COVID-19 vaccines are rare and reports of death after COVID-19 vaccination are very rare. According to the FDA and the Vaccine Adverse Event Reporting System (VAERS), reports of adverse events to VAERS following vaccination, including deaths, do not necessarily mean that a vaccine caused a health problem. For example, more than 562 million doses of COVID-19 vaccines were administered in the US from 14 December 2020 to 4 April 2022. During this time, VAERS received 13,853 preliminary reports of death (0.0025 per cent) among people who received a COVID-19 vaccine. It’s unclear whether the vaccine was the cause of any of these deaths.
In June 2021, Sierra Leone newspapers reported the death of a middle-aged woman in Port Loko following a SinoPharm COVID-19 vaccination. The Ministry of Health and Sanitation responded on 24 June 2021 that ‘the deceased had chronic disease and no relationship has been established between the death and the vaccination’. A Chinese representative in Sierra Leone, Zhou Shuisen, noted, ‘Over one billion doses of Chinese vaccines have been administered in and out of China with no single reported death directly associated with the Chinese vaccine. The incidence of severe reactions is 0.07 out of 100,000 doses, which means the Chinese vaccine is very safe.’
While severe reactions or adverse side effects are minimal, the WHO and CDC list mild reactions to vaccinations. They include slight pain at the injection site on the arm, mild swelling and a bit of redness. WHO also notes, following a vaccination, some people will feel tired, experience mild headaches, some muscle pain and a slight fever. These can be remedied by putting a cold cloth on the injection site and perhaps an over-the-counter pain relief.
Dr Sesay emphasised, ‘The benefits of COVID-19 vaccination far outweigh the known and potential risks.’ Randy Bangura, of Kissy Road in Freetown, said he took the COVID-19 vaccine because the Sierra Leone government said all government workers must be vaccinated. He said after the first jab he didn’t experience any negative side effects. But, he said when he went for the second jab, he felt sick, had diarrhoea, experienced a throbbing headache and a fever for two days. He made no official report of his symptoms to the vaccination site or the government.
‘The protocol, which every nurse who administers vaccines explains to people is if someone feels ill after getting a vaccination, they should report back to the vaccination site and talk to a nurse,’ said Dr Sesay. ‘The person receiving the vaccine will be asked to wait for 15–30 minutes before leaving the vaccination site so that health workers can observe individuals for any unexpected reactions following vaccination.’
Usually, the symptoms are very mild and the patient is advised to rest, drink lots of water and, if necessary, take a mild pain relief medication, he added. Adults may have some mild side effects from the vaccine, said Dr Sesay, which are normal signs that their body is building protection. These side effects may affect their ability to do daily activities, but they should go away in a few days. He emphasised, ‘The benefits of getting the vaccine outweigh any potential risks.’
Harold Thomas of the Risk Communications Pillar of the NaCOVERC in Sierra Leone said, ‘We’ve not had any reported serious side effect from any of the vaccines we have in Sierra Leone. We have a mechanism in place to identify potential serious cases of side effects but that has been silent. If a person has any side effects, they are usually very mild and clear up within a couple of days.’
Aminate Koroma of Royanka village, in the north of Sierra Leone said she felt sick for about a week after receiving a COVID-19 vaccination. She said, ‘I was not feeling well and went back to the hospital. There, the nurse did some tests and I found out I was pregnant. That’s probably why I was feeling tired, had some body-pains and needed rest.’
Health experts in Sierra Leone and NaCOVERC spokespeople noted there have been no serious adverse reactions or negative side effects to any of the COVID-19 vaccinations. That may or may not be true given the lack of diagnostic expertise and failed health system. One expert said, ‘We don’t know for sure if anyone in Sierra Leone has died or suffered serious side effects from the COVID-19 vaccines because we just don’t know.’
This reporting was supported by the International Women’s Media Foundation’s (iwmf.org), Global Health Reporting Initiative: Vaccines and Immunisation in Africa.